GROWTH AND DEVELOPMENT

 Growth (quantity)-increases in body size (height & weight). This occurs through cell division and
protein synthesis (Egg meets sperm/physical).
 Development (quality)-gradual growth from a lower to a more progressive skill and capacity to
function (cognitive and moral)
 Maturation-state of readiness where the body is more prepared to fulfill its function.
 Mass specific/Differentiation-the child masters simple operations before complex functions.
Also called gross-refined.
(Ex. Child learns to put on a shoe before tying a shoelace.)
 
PRINCIPLES OF GROWTH AND DEVELOPMENT
 PRINCIPLES of asynchronous growth-not all the body grow at once and at the same time.
 G&D is a continuous process beginning conception and ends in death.
 Play is the universal language and central to the life of a child.
 A great deal of skills and behaviour is learned by practice.
 Each child is unique.
 
FACTORS INFLUENCING HUMAN G&D.
 Genetic Factor-basic genetic make up of an individual that makes a child unique, also referred to
as hereditary.
 Race/nationality-some race are tall, some are short (genetic make up)
 Sex/gender-girls are born lighter than the boys by an ounce or 2, height can also be influenced
by gender
 Intelligence level-children who tend to be intelligent do not tend to grow physically but they
excel in advancement of skills (motor development is decereased.)
 Health-a child who inherits genetically transmitted disease my not grow as rapidly as the others
 Environmental influences-although children cannot grow taller than their genetically
programmed height potential allows, other factor may hinder their growth.
 Socio-economic level-children born of poor families cannot afford good nutrition. This caneven
make them vulnerable to certain diseases. (Vaccination)
 Cordinal position in the family-child who is eldest/only child develop his language skills because
he talks to adults more often. He tends to be healthy because all attention and allocation of
funds goes to him.
Children learn by watching other children. The eldest, since they do not have anyone to watch as
an example, tend to be poor on toilet training.
 Parent-child-relationsip-children who are loved thrive better than those who are not. There is
loss in desire to eat and play when there is disrupted parent-child-relationship.
 Illness and Injury-children who suffer from disease such as DM, hyperthyroidism, and etc. tend
to gain growth poorly.
 Exercise and stimulation-a child is who denied of play tends to become poorly developed & have
hindered growth.
 Nutrition-poor maternal nutrition may limit the growth and intelligence of the child. Diet can
also influence growth.
 
STAGES OF GROWTH AND DEVELOPMMENT
1. Prenatal/embryonic/fetal stage-begins conception to birth
2. Neonatal (first 28 days of life) /infancy (beyond 29 up to 12 months of life)-birth to 12 months
3. Early childhood stage-1 to 6 years of age (toddler (1 to 3 years)/preschool (4 to 6 years))
 4. Middle childhood (school age (6-11 years) /adolescence (12-16 years))
 
PATTERNS OF GROWTH AND DEVELOPMENT
 General growth (respiratory, digestive, renal, musculoskeletal and circulatory tissues)-proceeds,
smoothly and gradually during childhood. However, there are some body parts which mature
faster, than the others. And they are:
1. Neurologic tissue (brain and spinal cord)-grows rapdily in the 1st two to five years.
2. Lymphoid tissues-rapidly during infancy and childhood to provide protection to the child against
infection.
 
THEORIES OF GROWTH AND DEVELOPMENT.
 Theory-systematic statement of principles that provide framework for explaining phenomena.
 Developmental Task- a skill or growth responsibility arising at a particular time of an individuals
life. Achievement of each task will lead to accomplishment of future tasks.
 
FREUD'S THEORY OF PSYCHOSEXUAL DEVELOPMENT
Sigmund Freud (1856-19390
-an Australian neurologist and founder of psychoanalysis.
-he proposed psychosexual theory based on mentally disturbed clients.
-behavior is an instinctive drive (libido) with response to the ego (reality), id (self) and superego
(conscience)
 
 
 
PSYCHOSEXUAL/PSYCHOANALYTICAL THEORY
-child development who is a series of psychosexual stages in which a childs sexual gratification becomes
focused on particular body part.
 fixation -a condition in which a person failsto meet a certain task.
 
AGE GROUP PSYCHOSEXUAL STAGE IMPLICATIONS
 
INFANT Oral Stage:  Provide oral stimulation
  Child who explored the world using  Give pacifiers (E.O 51-
PLAY: solitary mouth. Sucks for enjoyment, relief of bawal because its only for
tension and nourishment. stimulation)
*Olfactory-one of the most sensitive  Don’t discourage thumb
senses of infant sucking
*T4-touch (initial contact)  Breastfeeding
 
 
TODDLER Anal Stage:  help achieve
   child learns and finds pleasure bowel/bladder control
PLAY: Parallel to control urination and w/o undue emphasis on
defecation. its importance.
 Elimination takes new  provide autonomy
importance.  don’t be too lax/strict
  Self discovery and way of  start bowel and bladder
exerting independence. training
 proper gap-3-5 yrs  
CBQ:  
 Walking  
 Seat on the pot-first sign of  
toilet training  
 Accomplishment of self  
independence
 Diaper-dry
 Child communicate to poop/pee
PRE SCHOOL Phallic Stage:  accept sexual interest
   child learns sexual identity (fonding of genitals)as
PLAY:Associative through awareness of genital normal area of
  area exploration.
no goal  masturbation and exhibitionism  offer alternatives anad set
is common. limits.
   Do not humiliate the child
 
 
SCHOOL AGE Latent Stage:  help child have positive
   Libido appears non active and experience to boost his
PLAY: dormant self esteem to prepare
Competitive  Libido is converted to concrete him for the conflicts of
thinking and physical activity. adolscence
 Schoolwork and chores make it  teachers and parents play
difficult for the Schooler to have an integral role in building
sexual interest. the character of the
 Significant person: Teacher schooler
ADOLESCENT Genital Stage:  provide appropriate
   learns sexual maturity and opportunity for the child
PLAY: establishes satisfactory to relate with the opposite
Intellectual relationship with the opposite sex.
  sex.  Let them verbalize feelings
Ideal games  Establishment of new sexual regarding new
aims & finding new love objects. relationships.
 Significant person:
Peers/Friends
 Prone of suicidal incident
 Critical stage
 
ERIKSONS PSYCHOSOCIAL DEVELOPMENT
 Erik erikson
 trained under the psychosexual theory and founded the psychosocial theory.
 a person's view of himself is more important than any instinctive drive in determinng ones
behavior.
PSYHOCSOCIAL DEVELOPMENT THEORY
 Conflict of 2 opposing forces at each stage. The reolsution of each conflict or accomplishment of
a developmental task of that stage allows the individual to go towards the next stage.
 
INFANT
(Trust vs. Mistrust)
 when a childs needs are met, discomforts removed quickly, cuddled, played with and talked to,
the child develops the sense of trust. (friendly, caring, trustworthy, compassionate, loving)
 but when the care is inconsistent, inadequate or rejecting, the child will develop mistrust. (loner,
difficulty to have friends, paranoid, divorced).
 Ex: Interchange primary care results mistrust
 Implication: provide a primary care gver, soft touch and sounds,visual stimulation and
involvement.
TODDLER
(Autonomy vs Shame/Doubt)
 Autonomy-self government or independence
 Negativism-the child always answers no, a defense mechanism used by children in pursuit for
independence.
 When parents appreciate the things a toddler does, like opening a candy bottle, flashing the
toiletetc., the child develops the sense of independence/autonomy (good leaders, independent,
with integrity)
 but, if their parents are impatient/ they do everything for their children, children are not
allowed to do what they want to do; they start to doubt their capabilities and develop shame
(tax, dependent, push-over, inferior)
 Implication: involve in decision making, offering choices, praise activity, don’t judge correctness
of one's decision.
PRESCHOOLER
(Initiative vs Guilt)
 Learning initiative is how to do things.
 when a child is given freedom to initiate motor play, or exposed to play materials like clay/finger
paint, or answered when ihe is asked, or allowed to fantasize, the child learns initiative (creative,
excellent in their field, not afraid to do things, vocal)
 But when a child is made to feel like play activities are bad, his questions stupid, they may
develop a sense of guilt (limited brainstorming/problem solving skills, they always need approval
of others, introverts, soft-spoken, copycat)
 Implication: allow them to play, do the things they want, but always provide safety and set
limitations.
SCHOOL AGE
(Industry vs Inferiority)
 After learning how to do new things, children now are tasked to do things well (industriousness)
 If a child works are praised or rewarded, on their achievement are acknowledged by parents,
they developed a sense of pride and their sense of industry grows (confident, creatve,
appreciative of anothers workds, perfects their crafts.)
 but when a childs work is ignored, efforts not seen, products considered as fruit of "busy work",
they become inferior, (inferiority complex, non-appreciative, always poor on things, not
interested, repeated failures).
 Implication: give rewards,, allow to participate in chores, let child assemble a small project so
the child will feel rewarded.
ADOLESCENT
(Identity vs role Confusion)
 Integrates everything that they have learned in the past to form a self image.
 If the adolescent is able to do so, he attains his identity (straight, determined, good in decision
making, credible)
 If the adolescent is unable to do so, he becomes unsure of himself, leading to identity crisis and
role confusion. They become ucnertain of what they can do, what they are and who they want
to be (lax, no direction, ambivalent, poor decision)
 Implication: avoid giving negative identity,. People w/o definite identity may prefer negative
identity rather than not having an identity at all. Give them opportunity to discuss their
emotions and events important to him. Offer support and praise for decision making.
YOUNG ADULT
(Intimacy vs Isolation)
 Intimacy is the ability to relate well with other people to attain long lasting friendship.
 If a person has a strong sense of identity, he is able to create a deeper frienship with another
person (ableto keep commitment, knows how to love)
 but if a person has role confusion, he cannot build a long lasting relationship because of
constant fear of rejection and in the ends to fall to love and becomes isolated (abortion, divorce
paranoia, insecure)
 Nurse Implication-provide avenue for verbalization of feelings. Make them feel that they belong.
Endorse them to groups which may be able to help.
MIDDLE ADULT
(Generativity vs Stagnation)
 Concern grows not just for themselves but to their families, community, and the world.
 If a person is able to assume different/various roles, they regain their sellf-worth and
generativity (productivity, involved in nation building, becomes active and renewed.)
 but if a person assumeds one role may find themselves unable to cope up with change (full time
mothers, life becomes boring, antiquated)
 Nurse implication-counsel regarding community involvement. Let them verbalize their fears.
OLD AGE
(Integrity vs Despair)
 if a person looks back at life and appreciates the choices he have made in the past, and is happy
for what is happening in his present life, he has a sense of integrity (helpful in bringing up
trusting grandchildren)
 but if a person wishes life to be relived all over again, looks back at life in regret, they may have
difficulty accepting the present, and in the end despaired (May have difficulty in child-rearing)
 
 
JEAN PIAGET
 Swiss psychologist who introduced concepts of cognitive development or the way children learn
and think.
 This theory is categorized into four stages which are called schemas (classify stages of cognitive
dev)
NEONATES
(Sensorimotor neonatal reflex)'
 1st to 28 days)-behavior is entirely reflexive
 There is little ti no cognitive /mental skill necessary to guide the actions of the neonate
 Actions of the child are highly reflective due to the "survival mode" of the child
INFANTS
(Sensorimotor stage aka practical intelligence) thinking and problemsulving are not yet available at this
age.
1. Primary circular reaction schema (1st -4th month)-knowledge attained through repetition of
behavior occuring within the body by accident.
2. Secondary circular reaction schema (4th-8th month)-knowledge attained from activities
separates from the body of the child
*object permanence objects continue to exist even though they are out of sight or changed in
some way (pee-a-boo) this also lays the foundation of trust.
 
3. Coordination of secondary reaction schema-infants begin to demonstrate goal directed
behavior.
TODDLER
4. Tertiary circular reaction schema (12-18th month)-child uses trial and error to discover new
characteristics of obejcts and events.
Invention of new means through mental combinations (8-24 month)-transition from SENSORIMOTOR
STAGE TO PREOPERATIONAL THOUGH. Child is able to think through action or mentally projectt solution
to a problem.
 
 
Preoperational Thought (2-7 years old) childs starts to used symbol to represent an object.
1. Pre-logical reasoning-faulty reasoning which leads to wrong conlcusion and judgement
 
PRE SCHOOLER
2. Intuitive thought (aka centering)-children look at something centering only to one characteristc
(bitter pills) this will lead to poor
 Conservation-ability to discern truth cen though physical properties change.
 Reversibility-ability to retrace steps
 Role Fantasy-how children went things to trun out (the sun was calling for me outside)
 Assimilation-taking in information and changing them to fill their idea. (stool tripped me)
 Egocentrism-ones thoughs are always better than the other
 Static thinking-inability to remember what he started talking about and in the end talks about a
different thing.
 
SCHOOL AGE
CONCRETE OPERATIONAL THOUGHT(17-21 yrs old)
 recognizes cause the effect relationship (understands beads and glass)
 inductive reasoning (specific to general)-toy is broken, toy is made of plastic therefor all plastic
toys are breakable.
 Systematic reasoning-uses memory to learn broad concepts (fruits) and subgroups of concept
(apple/oranges)
ADOLESCENT
FORMAL OPERATIONAL THOUGHT (12 years onwards)
-final form of cognitive development
 abstract reasoning-thinking in the forms of possibility (what if)
 deductive reasoning (general to specific)plastic toys breaks easily, I hold a plastic toy, this will
break easily.
 
LAWRENCE KHOLBERG (1927-1987)
 a psychologist who studied the reasoning of theboys and based his studies on Piagets theory.
His theory focused on the way childrenn gain knowledge or right and wrong (Moral reasoning)
THEORY OF MORAL DEVELOPMENT
 this can help identify how child may feel about illness, how dependable he is n carrying our self
care and etc.
 
The infant
 PRERELIGIOUS PERIOD-the main motivating force in this stage is the parents. Children learn that
an act is good if they are given approval by their parents and "bad" if they are scolded.
 Nursing implication: infants try hard to please, and their wrong doings are just due to immature
development.
*trust can develop a better spiritual orientation.
 
The toddler
 PUNISHMENT OBEDIENCE ORIENTATION-begin to formulate sense of right and wrong, but
reason is centered on "mother/father says no"
 Nursing implication: it is difficult for a child to follow instructions from others. Let the parents
instruct a certain toddler so as to follow a caregiver.
 
The preschooler
 PRECONVENTIONAL STAGE (stage of self interest)-child tends to be good out of his own interest
rather than out of true infant to do good. (spiritual motivation)
 Egocentrism-a child may do things for other for personal gains (If I fight, my mother wont like
me anymore)
 Nursing implication: children imitate what they see. Don’t let them see bad things as much as
possible.
 
The School Age
 CONVENTIONAL DEVELOPMENT or the NICE GIRL/BOYSTAGE
 Children engage in actions that are "nice" or fair rather than "rght" to gain approval of friends.
 AUTHORITY AND SOCIAL ORDER STAGE-they learn that law is enforced by walking guards or
police, and they learn that there are fixed rules. (you shouldn't steal, the police will arrest you)
 Nursing Implication: children may lie because they don’t want to be involved in a "not nice/fair"
"situation".
*they may not be able to provide selfcare. They only follow rules which are clearly enforced. (If
someone is watching)
 
The Adolescent
 POST CONVENTIONAL DEVELOPMENT (Stage of Social Contract)
 They believe in mutual benefit or reciprocity
 mature form or moral reasoning. Adolescent are capable of abstract thought and beging to act
right even if no one is around. (why it is bad to steal? "because my neighbor is deprived by their
possession.")
*They can carry out self care even w/o being told because they can not only undersstand the
importance of the measures but also the principles that certain things should be done because
they are right
 
  
COMMON ACCIDENTS
Infancy=mother (stranger anxiety)
C-choking
A-aspiration
F-fall
 
Toddler=parents/both (seperation anxiety)
B-birds
F-falls
P-poisoning
 
Preschooler=parents/siblings (body mutilation)
A-accident
M-motor vehicle
 
School Age=teacher/classmate (fear of displacement/lack of belongingness)
A-accident
M-motor vehicle
 
Adolescent=peers (altered body image)
A-accident